1. Field of the Invention
The present invention relates generally to assessment of the relative risk of injury to joints. Test kits and methods for diagnosing and monitoring the relative risk of joint injury are provided. The apparatus and methods beneficially permit targeted intervention to reduce the risk of joint injury and/or reduce the damage resulting from joint injury.
2. Description of the Related Art
Joint injuries, such as sprains, strains, ligament tears, and degeneration of cartilage, may be chronic (i.e., occur as a result of aging, lack of use, or overuse), or acute (i.e., occur as a result of accident or trauma). Combinations of these factors may work together to contribute to joint injuries.
Biomechanical movement and neuromuscular risk factors associated with joint injury have recently begun to emerge, particularly with respect to injury to the anterior cruciate ligament (ACL) (6). High risk biomechanical movement patterns can result in the transmission of ground reaction forces to the knee, which in turn increase the compressive forces in the joint (7). Specifically, frontal plane motions, such as excessive knee abduction angle during landing maneuvers, may result in increased axial compression that can lead to traumatic ACL rupture (11). Hewett et al. (23) demonstrated that landing with excessive knee abduction is a prospective risk factor for subsequent ACL injury. It has been suggested that abnormal joint loading during activity may also accelerate the initiation and progression of osteoarthritis, particularly in the knee (16, 17, 44).
Despite the promising data that suggest certain high risk movement patterns may predispose individuals to joint injury, little is known about how these movement patterns might affect biochemical processes associated with cartilage, bone, muscle, ligament, and tendon metabolism. More specifically, little is known about how pre-injury cartilage turnover and metabolism are associated with subsequent joint injury.
Efforts to use biomarkers to predict the onset of osteoarthritis are underway. Since ACL injuries may lead to arthritis, an area of research has evolved around studying the earliest stages of arthritis that may occur following major knee joint injuries, such as ACL tears, by using biomarkers. For example, U.S. Published Patent Application No. 2011/0218116 describes biomarkers and methods for diagnosing osteoarthritis, based on measurement of the expression of polypeptides including MCP1,IL8, KC, MMP2, MMP3, IL6, MMP1, RANTES, MMP9, IL1B, Apolipoprotein A1, Apolipoprotein E, DCN, CILP and COMP.
However, such methods of using biomarkers assess the impact of joint injuries only after they have occurred, and do not permit a determination of those at risk for such injuries. Accordingly, there remains a need in the art for tools and methods for assessing the risk of joint injury.